Gilead ESI Survey – Hilliard Martinez Gonzales, LLP

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Case Number

First Name

Last Name

Do you have any social media accounts?

Which social media accounts? (Please select all that apply)

Please list any other social media accounts?

Do you have an email account?

Email account 1

Email account 2

Are your text messages, voicemails, voicemail transcripts, or instant messages stored in a location outside of your cell phone? (i.e., iCloud, email, etc.)

Which ways do you store text messages, voicemails, voicemail transcripts, or instant messages? (Please select all that apply)

Please list any other ways do you store text messages, voicemails, voicemail transcripts, or instant messages?

Have you made any communications (posts/comments/messages) via social media, text, or e- mail regarding kidney issues?

Please select from the list any communications (posts/comments/messages) via social media, text, or e-mail regarding kidney issues? (Please select all that apply)

Any other communications (posts/comments/messages) via social media, text, or e-mail regarding kidney issues?

Have you made any communications (posts/comments/messages) via social media, text, or e- mail regarding bone injuries?

Please select from the list any communications (posts/comments/messages) via social media, text, or e-mail regarding bone injuries? (Please select all that apply)

Please list any other communications (posts/comments/messages) via social media, text, or e-mail regarding bone injuries?

Have you made any communications (posts/comments/messages) via social media, text, or e- mail regarding HIV medications?

Please select from the list any communications (posts/comments/messages) via social media, text, or e-mail regarding HIV medications? (Please select all that apply)

Please list any other communications (posts/comments/messages) via social media, text, or e-mail regarding HIV medications?

Have you made any communications (posts/comments/messages) via social media, text, or e- mail regarding emotional injuries?

Please select from the list any communications (posts/comments/messages) via social media, text, or e-mail regarding emotional injuries? (Please select all that apply)

Please list any other communications (posts/comments/messages) via social media, text, or e-mail regarding emotional injuries?

Have you had any communications including but not limited to comments/posts/messages related to the lawsuit against Gilead?

Are there any other ways that you have had communications related to the lawsuit against Gilead?

Phone

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